“Wise Interventions”: Economical alternatives to EBPs in Youth Mental Health?
Wise interventions (WIs) are precise, theory- and research-based techniques that address specific psychological processes to help people flourish across diverse life domains. WIs emphasize subjective meaning-making: how people make sense of themselves and social worlds. In turn, they can spur changes in beliefs and behavior in ways that accrue over time. In controlled studies and field trials, WIs have yielded benefits for academic, interpersonal, and health-related outcomes for youth.
WIs focus on (are “wise to”) the meanings and inferences people draw about themselves, other people, or a situation they are in and use precise, theory- and research-based techniques to alter these meanings. Consistent with cognitive-behavioral models of psychopathology WIs are rooted in the scientific premise that people’s behavior stems from their interpretations of themselves and their social environment—and that those interpretations are modifiable through targeted, precise interventions.
WIs both overlap with and differ from traditional cognitive-behavioral therapies. Their primary similarity rests in the types of basic, motivational human needs that WIs are designed to address:
- Need for accuracy (correspondence between perception of the world and lived experience or reality)
- Need for self-integrity (thinking well of one’s self), or
- Need for belongingness (maintaining positive relationships with members of valued groups).
Traditional EBTs for youth internalizing and externalizing psychopathology routinely address one or more of these needs. Thus, both WIs and many traditional EBTs focus explicitly on modifying a shared set of beliefs to foster adaptive behavior change. Other characteristics of WIs differentiate them from EBTs, which are generally designed for delivery by trained therapists in brick-and-mortar clinical settings.
First, WIs are designed as single-component interventions: Interventions that include a streamlined, focused activity to support adoption of a specific meaning-making strategy. Accordingly, WIs tend to be extremely brief, including just one or a handful of sessions.
Second, WIs are explicitly focused on shifting participants’ beliefs in order to spur ‘recursive’ recovery processes, whereby shifts in key beliefs facilitate behavior change, which in turn reinforce initial, adaptive belief change—ultimately supporting long-term progress both cognitively and behaviorally. That is, the effects of WIs rely almost entirely on personally-guided learning embedded in real-world experiences.
Finally, WIs and traditional EBTs are structured and presented to participants in notably different ways. WIs are designed to be non-stigmatizing, unobtrusive (e.g., delivered via technology or lay providers in real-world contexts they regularly frequent, rather than separate, clinical settings), and relevant to youths with and without severe psychopathology.
Three WIs are well-studied and have proven effective in improving academic and interpersonal outcomes in youth:
- Self-affirmation interventions
- Mental contrasting with implementation intentions
- Growth mindset interventions.
Self-affirmation interventions give participants opportunities to assert their core values, especially when those values might be under threat. These affirmations often involve brief writing sessions (as short as 10 minutes) where participants write about themselves in a way that affirms a positive, authentic sense of self. These affirmations can be about large personal accomplishments, but even “small” affirmations can have out-sized effects on participants if they are personally meaningful.
Mental Contrasting with Implementation Intentions (MCII) is a self-regulation strategy designed to increase both goal commitment (via mental contrasting), and in turn, likelihood of goal implementation (through implementation intentions). In completing MCII, individuals first name their most important wish in a particular domain, such as academics. Second, participants imagine and elaborate the desired future of having successfully fully addressed this concern. Lastly, they imagine and elaborate the primary obstacle in the way of realizing their wish.
Growth Mindset (Incremental Theory) Interventions encourage participants to believe traits are malleable (growth mindset) rather than unchangeable (fixed mindset). Endorsing this growth mindset in turn may lead to greater effort, more help seeking, and better outcomes in important domains like interpersonal functioning and academics.
A recent paper outlines how WIs might be harnessed to help address specific maladaptive beliefs underlying youth psychopathology. WIs are viewed as well-targeted, theoretically precise strategies to mitigate cognitive vulnerabilities, thereby increasing adaptive coping and reducing hopelessness, aggression, and distress in the face of setbacks and stressors.